Switch therapy with beta-lactam/beta-lactamase inhibitors in patients with community-acquired pneumonia.
BACKGROUND
Antimicrobial drugs are prescribed inappropriately nearly 50% of the time. To address this problem, a hospital antimicrobial team was formed integrating the talents of infectious disease physicians, pharmacists, microbiologists, infectious control practitioners, and nurses. The primary goal of the team is to provide optimal, cost-effective antimicrobial therapy.


OBJECTIVE
To review the principles of streamlining antimicrobial therapy, with an emphasis on antibiotic switch therapy.


CONCLUSIONS
With appropriate guidelines, switch therapy appears to be an important means to provide optimal antimicrobial therapy complementing the many social pressures placed on patients, while positively impacting on the overall cost of treatment. The use of beta-lactam/beta-lactamase inhibitor combinations as the antibiotics for initial intravenous medication to oral combination switch therapy is a viable approach to the treatment of hospitalized patients with community-acquired pneumonia. Preliminary data from our institution were obtained with such a therapeutic approach to assess the clinical efficacy, patient satisfaction with their care, and calculated dollar savings in the overall cost of care. The results of this evaluation strongly support the validity and desirability of such an approach.


CONCLUSIONS
The prospective use of a program that incorporates the use of beta-lactam/beta-lactamase inhibitor combinations for intravenous and switch-to-oral drug administration is a cost-effective means of providing optimal antimicrobial therapy for patients with community-acquired pneumonia.
Ramirez
J A
JA
Department of Medicine, School of Medicine, University of Louisville, KY 40292, USA.
D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000191:economics; D004359:Drug Therapy, Combination / Q000008:administration & dosage* / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D017060:Patient Satisfaction; D011014:Pneumonia / Q000188:drug therapy* / Q000191:economics; D016896:Treatment Outcome; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D065093:beta-Lactamase Inhibitors; D047090:beta-Lactams